Implementation of EVIPNet in Kyrgyzstan

Round Table on the Situation Analysis and Overview of Using Evidence in Policy-Making was held on December 10-11, 2015 in Bishkek with the assistance of WHO Country Office.

Target audience included management and specialists of the MoH, all National Centers and Research Institutions, higher medical educational institutions, relevant NGOs and the academic and scientific community representatives.

Evidence-Informed Policy Network (EVIPNet) is a WHO initiative that promotes the systematic use of health research evidence in policy-making.

EVIPNet Europe is a key support mechanism for the implementation of the European policy framework Health 2020. The knowledge translation platforms (KTPs) established through

EVIPNet Europe will help countries to translate knowledge into policy. More detailed information about EVIPNet-Europe can be found at the website: www.evipnet.org

As far as Kyrgyzstan has joined the EVIPNet-Europe, in order to establish the KTP locally the situation analysis was done and its findings were presented at the round table as well as the KTP establishment scenarios were discussed.

Round Table Agenda(PDF-1)

Presentation on the Preliminary Situation Analysis Findings(PDF-2)

M&E workshop for oblast level specialists and staff of the MoH

Based on a request from the Ministry of Health of the Kyrgyz Republic, on 12-13 November, 2015 theHPAC organized the workshop on «Monitoring and evaluation of health organizations’ performance in the framework of National “Den Sooluk” Health Care Reform Program of the Kyrgyz Republic for 2012-2016».

This workshop was aimed at improving practical skills for analysis and interpretation of data collected as well as preparation of reports on monitoring and evaluation of Den Sooluk Program within the confines of four priority areas: Mother and Child Health, CVD, TB and AIDS.

Core trainers of the workshop were Rakhat Cholurova (Policy and Service Delivery Expert of the Defeat TB Project) and Olga Kindyakova (Deputy Director of RHIC). Specialists directly involved in data collection, analysis and interpretation and, namely, deputy oblast  coordinators responsible for monitoring and evaluation of oblast health system performance, directors of oblast health information centers, chiefs of health information units of Bishkek and Osh health departments as well as technical coordinators of the KR MoH, responsible for monitoring and evaluation within four priority areas of Den Sooluk Program at the national level took part in the workshop.

The workshop participants remained happy with the content and organization quality of the workshop and expressed their hope that similar workshops will be conducted also for technical specialists responsible for monitoring at raion level, since, in their view, this will contribute to the reliability and quality of data collection, high-quality analysis and correct interpretation.

Decree of the MoH (including agenda and list of participants)(PDF-1)

List of participants with signatures(PDF-2)

WHO Flagship Course on HSS with focus on NCDs

09-13 May 2016, Barcelona, Spain

The WHO Regional Office for Europe is pleased to announce the next annual Flagship Course on Health Systems Strengthening to be held from 9 to 13 May 2016 in Barcelona, Spain. This week-long intensive course is offered by the Division of Health Systems and Public Health of the WHO Regional Office for Europe through the WHO Barcelona Office for Health Systems Strengthening. We invite you and your colleagues to participate in this exclusive training event.

The course focuses on policy options to address health system barriers to address the growing burdern of non-communicable diseases.

The course is delivered in English with simultaneous translation to Russian.

Applicants are invited to submit a completed online application form available on the course website:

https://extranet.who.int/datacol/survey.asp?survey_id=3396

Please use Flagship2016 as user name and password.

Please note that the deadline for receiving applications is 17 March 2016. To secure participation in the course, accepted participants will be charged a fee of EUR 300. The fee is payable upon acceptance of application. Once paid, this payment is non-refundable in case of cancellation. WHO will cover tuition, course materials, coffee breaks and lunches on all five days of the course, plus one dinner reception. Participants will be responsible for covering the costs of travel, accommodation and subsistence while in Barcelona.

A brochure of the course with further details is here.(PDF-1)

Better non-communicable disease outcomes: challenges and opportunities for health systems. Kyrgyzstan Country Assessment: Focus on cardiovascular disease

Melitta Jakab, Barton Smith, Nina Sautenkova, Aida Abdraimova, Adyl Temirov, Ryskul Kadyralieva, Suyumjan Mukeeva, Larissa Murzakarimovna

Cardiovascular mortality in Kyrgyzstan has decreased over the past seven years in part due to impressive health system reforms. However, moving towards the 25 by 25 targets and addressing the sizeable gender gap in premature mortality present a significant challenge. While Kyrgyzstan has made some strides in implementing anti-smoking policies, reducing the harmful effects of alcohol, and strengthening nutrition policies, there are still great opportunities through better enforcement and monitoring of legislation. Significant challenges also remain for coverage of core individual services especially in the effective diagnosis and management of key cardiovascular disease conditions, such as hypertension, and diabetes. The report identifies key health system challenges that prevent greater coverage of core NCD interventions and services and proposes three strategic directions to accelerate gains in CVD outcomes.

Better non-communicable disease outcomes: challenges and opportunities for health systems(PDF-1)

Analysis of stroke diagnosis verification in patients that died at home

Turgunbayev D.D., Artykbayev A.Sh., Kadyrova N., Abdraimova А., Urmanbetova А.

Kyrgyzstan has the highest mortality rate caused by cerebrovascular diseases in the European region, exceeding the figures for Kazakhstan, Russia, Moldova, CIS, EU – C and EU – A in more than 10-times. Stroke is one of the major death causes that stipulate low life expectancy in the Kyrgyz Republic. Analysis of RHIC statistical data indicates that stroke-related mortality exceeds morbidity rates. Currently, there is no appropriate stroke diagnostics (computer tomography and/or magnetic resonance imaging (CT/MRI)), so according to the HPAU’s study of 2007 the share of patients that had CT/MRI in regions was 16% and it included only patients treated in Bishkek. Therefore, stroke diagnostics is currently mainly based on methods of clinical examination of patients and doctor’s personal experience. Therefore, the study was aimed at verification of stroke diagnosis in persons that died at home, in other words, in outpatient setting on the basis of clinical documentation analysis.   

Analysis of “stroke” diagnosis verification in patients that died at home(PDF-1)

Cost estimation of medicinal treatment of hypertension in the Kyrgyz Republic with the view of creating possible drug supply mechanisms ensuring free-of-charge HTN treatment

Abdraimova A., Urmanbetova A., Borchubaeva G., Azizbekova J.

Hypertension is the leading cause of mortality and disability in Kyrgyzstan among other cardio-vascular diseases. It was demonstrated that share of hypertension combined with hyperlipidemia and coronary heart disease that contribute to mortality and disability rates from CVDs measures up to 80% . Hypertension incidence continues to grow reaching from 30.1% in adult population to 34.1% in the age group of 18+ . Den Sooluk Health Reform  Program segregates measures on improvement of hypertension detection and control into separate group of performance indicators on CVD which in combination with other performance indicators are expected to lead to annual 1% reduction in CVD mortality rates. Kyrgyzstan has made tremendous efforts to improve primary health care. Hypertension control was emphasized in this process as one of the monitored conditions. In addition, State-guaranteed Benefit Package (SGBP) and Additional Drug Package for insured population at outpatient level were designed to ensure affordability of health services on detection and treatment of various conditions including hypertension. The focus of this research was to study the issue of affordability of antihypertensive drugs, i.e. cost of drug therapy, since effective hypertension control can improve health outcomes by reducing acute CVD cases such as stroke and myocardial infarction and be cost-effective for the health system by reducing hospitalization rates.

Cost estimation of medical treatment of hypertension in the Kyrgyz Republic with the view of creating possible drug supply mechanisms ensuring HTN treatment for free(PDF-1)

Discussion of draft report on M&E of medical education reforms

On December 23, 2015 the discussion of draft report on monitoring and evaluation of reforms in undergraduate, postgraduate and continuous medical education (2015-2017) took place in the HPAC office. The working group members participated in the discussion, namely, representatives of the MoH, medical educational institutions, staff members of NGO “The initiatives in medical education” and PF “Health Policy Analysis Center”. The objective of the discussion was to familiarize the participants with the preliminary findings obtained within the frames of M&E of medical education system reforms as well as to get feedback and comments so as to finalize the report and present it to broader audience.

Evaluation of nurses’ role in management of NCDs

Health Policy Analysis Center conducted evaluation of nurses’ role in management of some non-communicable diseases (specifically, diabetes, hypertension, COPD, palliative care) with financial support from Swiss Embassy in the Kyrgyz Republic and the Reforms in Medical Education in the Kyrgyz Republic Project.

The purpose of this study was to evaluate role of nurses in care delivery to patients with some non-communicable diseases as well as barriers preventing the involvement of nurses in the process of effective management of patients with some NCDs.

The research objectives included the following:

• Evaluation of existing family doctors’ and nurses’ role and practice in NCD management (diabetes, hypertension, COPD, palliative care) in health organizations;

• Review of family doctors’ and nurses’ activity arrangement within NCD management and identification of barriers to extend role of nurses in management of some NCDs based on views of doctors, patients and nurses;

• Evaluation of nurses’ knowledge and skills and related gaps at the level of education;

• Identification of family doctors’ and nurses’ needs and the areas requiring further efforts and needed interventions to efficiently manage NCDs and increase the role of nurses in NCD management.

Based on the obtained findings, the preliminary report including recommendations has been developed for consideration of stakeholders.